Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links.

PTSD: National Center for PTSD

Menu
Menu
Quick Links
Veterans Crisis Line Badge
My healthevet badge
 

Rural Provider PTSD Toolkit

 

Rural Provider PTSD Toolkit

 
References
1
U.S. Census Bureau (2011). American Community Survey 5-Year Estimates. 2011. S1903-Median Income in the past, 12.
2
2017 Survey of veteran enrollees' health and use of health care. VHA Office of Strategic Planning and Analysis (OSPA).
3
Weeks, W. B., Kazis, L. E., Shen, Y., Cong, Z., Ren, X. S., Miller, D., Lee, A., & Perlin, J. B. (2004). Differences in health-related quality of life in rural and urban veterans. American Journal of Public Health, 94, 1762-1767. doi:10.2105/AJPH.94.10.1762
4
Charlton, M. E., Mengeling, M. A., Schlichting, J. A., Jiang, L., Turvey, C., Trivedi, A. N., & West, A. N. (2016). Veteran use of health care systems in rural states: Comparing VA and Non‐VA health care use among privately insured veterans under age 65. The Journal of Rural Health, 32, 407-417. doi:10.1111/jrh.12206
5
Pietrzak, R. H., Goldstein, R. B., Southwick, S. M., & Grant, B. F. (2011). Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Anxiety Disorders, 25, 456-465. doi:10.1016/j.janxdis.2010.010
6
Galatzer‐Levy, I. R., Nickerson, A., Litz, B. T., & Marmar, C. R. (2013). Patterns of lifetime PTSD comorbidity: A latent class analysis. Journal of Depression and Anxiety, 30, 489-496. doi:10.1002/da.22048
7
Iverson, K. M., Hendricks, A. M., Kimerling, R., Krengel, M., Meterko, M., Stolzmann, M. S., . . . Lew, H. L. (2011) Psychiatric diagnoses and neurobehavioral symptom severity among OEF/OIF VA patients with deployment-related traumatic brain injury: A gender comparison. Women's Health Issues, 21, S210-217. doi:10.1016/j.whi.2011.04.019
8
Sareen, J., Cox, B. J., Stein, M. B., Afifi, T. O., Fleet, C., & Asmundson, G. J. (2007). Physical and mental comorbidity, disability, and suicidal behavior associated with posttraumatic stress disorder in a large community sample. Psychosomatic Medicine, 69, 242-248. doi:10.1097/PSY.0b013e31803146d8
9
McCarthy, J. F., Blow, F. C., Ignacio, R. V., Ilgen, M. A., Austin, K. L., & Valenstein, M. (2012). Suicide among patients in the Veterans Affairs Health System: Rural-urban differences in rates, risks, and methods. American Journal of Public Health, 102, S111-S117. doi:10.2105/AJPH.2011.300463
10
Department of Veterans Affairs. (2011). Fact sheet: VA Suicide Prevention Program facts about veteran suicide. Washington, DC: Department of Veterans Affairs Office of Patient Care Services Office of Mental Health Service.
11
Lew, H.L., Otis, J.D., Tun, C., Kerns, R.D., Clark, M.E., Cifu D.X. (2009). Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: Polytrauma clinical triad. Journal of Rehabilitation Research & Development, 46, 697-702. doi:10.1682/JRRD.2009.01.0006
12
Bernardy, N. C., Lund, B. C., Alexander, B., & Friedman, M. J. (2014). Increased polysedative use in veterans with posttraumatic stress disorder. Pain Medicine, 15, 1083-1090. doi:10.1111/pme.12321
13
Powell, M. A., Corbo, V., Fonda, J. R., Otis, J. D., Milberg, W. P., & McGlinchey, R. E. (2015). Sleep quality and reexperiencing symptoms of PTSD are associated with current pain in U.S. OEF/OIF/OND veterans with and without mTBIs. Journal of Traumatic Stress, 28, 322-329. doi:10.1002/jts.22027
14
Seal, K.H., Shi, Y., Cohen, G., Maguen, S., Krebs, E. E. & Neylan, T. C. (2017). Association of mental health disorders with prescription opioids and high-risk opioid use in U.S. veterans of Iraq and Afghanistan. JAMA, 307, 940-947. doi:10.1001/jama.2012.234
15
Park, T. W., Saitz, R., Ganoczy, D., Ilgen, M. A., & Bohnert, A. S. (2015). Benzodiazepine prescribing patterns and deaths from drug overdose among U.S. veterans receiving opioid analgesics: Case-cohort study. British Medical Journal, 350, h2698. doi:10.1136/bmj.h2698
16
Collett, G. A., Song, K., Jaramillo, C. A., Potter, J. S., Finley, E. P. & Pugh, M. J. (2016). Prevalence of central nervous system polypharmacy and associations with overdose and suicide-related behaviors in Iraq and Afghanistan War veterans in VA care 2010-2011. Drugs Real World Outcomes, 3, 45-52. doi:10.1007/s40801-015-0055-0
17
Paulozzi L. J., & Xi Y. (2008). Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type. Pharmacoepidemiology & Drug Safety, 17, 997-1005. doi:10.1002/pds.1626
18
U.S. Department of Veterans Affairs & U.S. Department of Defense. (2017). VA/DOD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder (Version 3.0). Retrieved from: https://www.healthquality.va.gov/guidelines/MH/ptsd/
19
Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-Analysis Meta-Analysis of the Efficacy of Treatments. Journal of Clinical Psychiatry, 74(6), e541-e550.
20
Lee, D. J., Schnitzlein, C. W., Wolf, J. P., Vythilingam, M., Rasmusson, A. M., & Hoge, C. W. (2016). Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: Systemic review and meta‐analyses to determine first‐line treatments. Depression and Anxiety, 33(9), 792-806.
21
Guina, J., Rosseter, S.R., DeRhodes, B.J., Nahhas, R.W. & Welton, R.S. (2015). Benzodiazepines for PTSD: A systematic review and meta-analysis. Journal of Psychiatry Practice, 2, 281-303. doi:10.1097/PRA.0000000000000091
22
DiPiro, J.T., Talbert, R.L., Yee, G.C., Matzke G.R., Wells, B.G., Posey, L.M (2014). Pharmacotherapy: A pathophysiologic approach (9th edition). McGraw-Hill Medical.
23
Lund, B.C., Bernardy, N.C., Alexander, B. & Friedman, M.J. (2012). Declining benzodiazepine use in veterans with posttraumatic stress disorder. Journal of Clinical Psychiatry, 73, 292-296. doi:10.4088/JCP.10m06775
24
Lund, B. C., Abrams, T. E., Bernardy, N. C., Alexander, B., & Friedman, M. J. (2013). Benzodiazepine prescribing variation and clinical uncertainty in treating posttraumatic stress disorder. Psychiatry Services, 64, 21-27. doi:10.1176/appi.ps.201100544
25
Barnett, E. R., Bernardy, N. C., Jenkyn, A. B., Parker, L. E., Lund, B. C., Alexander, B., & Friedman, M. J. (2014). Prescribing clinicians' perspectives on evidence-based psychotherapy for posttraumatic stress disorder. Behavioral Sciences, 4, 410-422. doi:10.3390/bs4040410
26
Jansen, J., Naganathan, V., Carter, S. M., McLachlan, A. J., Nickel, B., Irwig, L., . . . McCaffery, K. (2016). Too much medicine in older people? Deprescribing through shared decision making. British Medical Journal, 3, 353, i2893. doi:10.1136/bmj.i2893
27
Mott, J. M., Grubbs, K. M., Sansgiry, S., Fortney, J. C., & Cully, J. A. (2015). Psychotherapy utilization among rural and urban veterans from 2007 to 2010. Journal of Rural Health, 31, 235-243. doi:10.1111/jrh.12099
28
Sullivan, G., Hunt, J., Haynes, T. F., Bryant, K., Cheney, A. M., Pyne, J. M., . . . Richison, R. (2014). Building partnerships with rural Arkansas faith communities to promote veterans' mental health: Lessons learned. Progress in Community Health Partnerships : Research, Education, and Action, 8, 11-19. doi:10.1353/cpr.2014.0004
29
Sullivan, S., Pyne, J. M., Cheney, A. M., Hunt, J., Haynes, T. F., & Sullivan, G. (2014). The pew versus the couch: Relationship between mental health and faith communities and lessons learned from a VA/clergy partnership project. Journal of Religion and Health, 53(4), 1267-1282.
30
Lamkin, J., Stevens, J., Fortney, J. C., Cully, J., & Hundt, N. The influence of social support networks on veteran treatment-seeking for PTSD, in press.
31
Fortney, J. C., Pyne, J. M., Kimbrell, T. A., Hudson, T. J., Robinson, D. E., Schneider, R., . . . Schnurr, P. P. (2015). Telemedicine-based collaborative care for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 72, 58-67. doi:10.1001/jamapsychiatry.2014.1575
32
Lave, J., & Wenger, E. (1998). Communities of practice: Learning, meaning, and identity.
33
Richardson, L. K., Frueh, B. C., Grubaugh, A. L., Egede, L., & Elhai, J. D. (2009). Current directions in videoconferencing tele‐mental health research. Clinical Psychology: Science and Practice, 16, 323-338. doi:10.1111/j.1468-2850.2009.01170.x
34
Gros, D. F., Yoder, M., Tuerk, P. W., Lozano, B. E., & Acierno, R. (2011). Exposure therapy for PTSD delivered to veterans via telehealth: Predictors of treatment completion and outcome and comparison to treatment delivered in person. Behavior Therapy, 42, 276-283. doi:10.1016/j.beth.2010.07.005
35
Frueh, B. C., Monnier, J., Yim, E., Grubaugh, A. L., Hamner, M. B., & Knapp, R. G. (2007). A randomized trial of telepsychiatry for post-traumatic stress disorder. Journal of Telemedicine and Telecare, 13, 142-147. doi:10.1258/135763307780677604
36
Morland, L. A., Mackintosh, M. A., Greene, C. J., Rosen, C. S., Chard, K. M., Resick, P. A., & Frueh, B. C. (2014). Cognitive Processing Therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: A randomized noninferiority clinical trial. Journal of Clinical Psychiatry, 75, 470-476. doi:10.4088/JCP.13m08842
37
Acierno, R., Knapp, R., Tuerk, P., Gilmore, A.K., Lejuez, C., Ruggiero, K., . . . Foa, E. B. (2017). A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth. Behavior Research Therapy, 89, 57-65. doi:10.1016/j.brat.2016.11.009
38
Department of Veterans Affairs (2017). Suicide among veterans and other Americans: 2001-2014.
39
Hirsch, J. K., & Cukrowicz, K. C. (2014). Suicide in rural areas: An updated review of the literature. Journal of Rural Mental Health, 38, 65. doi:10.1037/rmh0000018
40
Centers for Disease Control and Prevention. (2015). Age-Adjusted Rates for Suicide, by Urbanization of County of Residence -- United States, 2004 and 2013. In (Vol. 64, pp. 401). Morbidity and Mortality Weekly Report.
41
Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., & Kessler, R. C. (2011). Barriers to mental health treatment: Results from the National Comorbidity Survey replication. Psychological Medicine, 41, 1751-1761. doi:10.1017/S0033291710002291
42
McFaul, M. B., Mohatt, N. V., & DeHay, T. L. (2014). Development, evaluation, and refinement of the Suicide Prevention Toolkit for Rural Primary Care Practices. Journal of Rural Mental Health, I, 116-127. doi:10.1037/rmh0000020
43
Cheney, A.M., Koenig, C.J., Miller, C.J., Zamora, K., Wright, P., Stanley, R., ... Pyne, J.M. (2018). Veteran-centered barriers to VA mental healthcare services use. BMC Health Services Research,18(1):591. doi: 10.1186/s12913-018-3346-9.
44
Department of Veterans Affairs, Office of Rural Health. (2014). 2012-2014 VA ORH Strategic Plan Retrieved from: http://www.ruralhealth.va.gov/docs/ORH_StrategicPlanRefresh_FY2012-2014.pdf.
45
Wallace, A. E., Weeks, W. B., Wang, S., Lee, A. F., & Kazis, L. E. (2006). Rural and urban disparities in health-related quality of life among veterans with psychiatric disorders. Psychiatric Services, 57, 851-856. doi:10.1176/ps.2006.57.6.851
46
Homaifar, B., Matarazzo, B., & Wortzel, H. S. (2013). Therapeutic risk management of the suicidal patient: Augmenting clinical suicide risk assessment with structured instruments. Journal of Psychiatric Practice, 19, 406-409. doi:10.1097/01.pra.0000435039.68179.70
47
Wortzel, H.S., Homaifar, B., Matarazzo, B., & Brenner L.A. (2014). Therapeutic risk management of the suicidal patient: Stratifying risk in terms of severity and temporality. Journal of Psychiatric Practice, 20, 63-67. doi:10.1097/01.pra.0000442940.46328.63
48
Department of Veterans Affairs and Department of Defense (2013). VA/DoD Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide.
49
Stanley, B., Brown, G. K., Karlin, B., Kemp, J. E., & VonBergen, H. A. (2008). Safety plan treatment manual to reduce suicide risk: Veteran version. Washington, DC: United States Department of Veterans Affairs.
50
Tannenbaum, C., Martin, P., Tamblyn, R., Benedetti, A., & Ahmed, S. (2014). Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: The EMPOWER cluster randomized trial. JAMA, 174, 890-898. doi:10.1001/jamainternmed.2014.949 F
51
Freudenberger, H. J. (1975). The staff burnout syndrome in alternative institutions. Psychotherapy: Theory, Research, & Practice, 12, 73-82. doi:10.1037/h0086411
52
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397-422. doi:10.1146/annurev.psych.52.1.397
53
Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administrative Policy Mental Health, 39, 341-352. doi:10.1007/s10488-011-0352-1
54
Barnett, J. E., Baker, E. K., Elman, N. S., & Schoener, G. R. (2007). In pursuit of wellness: The self-care imperative. Professional Psychology: Research and Practice, 38, 603-612. doi:10.1037/0735-7028.38.6.603
55
Smith, A. J., Kleijn, W. C., Trijsburg, R. W., & Hutschemaekers, G. J. (2007). How therapists cope with clients' traumatic experiences. Torture, 17, 203-215. Retrieved from https://irct.org/assets/uploads/1018-8185_2007-3_203-215.pdf
56
Robinson-Keilig, R. A. (2014). Secondary traumatic stress and disruptions to interpersonal functioning among mental health therapists. Journal of Interpersonal Violence, 29, 1477-1496. doi: 10.1177/0886260513507135
57
Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work Journal, 35, 155-163. doi:10.1007/s10615-007-0091-7
58
Bride, B. E., (2007).Measuring compassion fatigue. Clinical Social Work Journal, 35, 155-163. doi:10.1007/s10615-007-0091-7.
59
Pearlman, L., & Saakvitne, K. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York, NY: W. W. Norton & Co.
60
Sabin-Farrell, R., & Turpin, G. (2003). Vicarious traumatization: Implications for the mental health of health workers? Clinical Psychology Review, 23, 449-480.
61
Devilly, G. J., Wright, R., & Varker, T. (2009). Vicarious trauma, secondary traumatic stress or simply burnout? Effect of trauma therapy on mental health professionals. Australian and New Zealand Journal of Psychiatry, 43, 373-385. doi:10.1080/00048670902721079
62
Cieslak, R., Shoji, K., Douglas, A., Melville, E., Luszczynska, A., & Benight, C. C. (2014). A meta-analysis of the relationship between job burnout and secondary traumatic stress among workers with indirect exposure to trauma. Psychological Services, 11, 75-86. doi:10.1037/a0033798
63
Vuori, J., Toppinen-Tanner, S., & Mutanen, P. (2012). Effects of resource-building group intervention on career management and mental health in work organizations: Randomized controlled field trial. Journal of Applied Psychology, 97, 273-286. doi:10.1037/a0025584
64
Lyssenko, L., Müller, G., Kleindienst, N., Schmahl, C., Berger, M., Eifert, G., . . . Bohus, M. (2015). Life Balance-a mindfulness-based mental health promotion program: Conceptualization, implementation, compliance and user satisfaction in a field setting. BMC Public Health, 15, 740. doi:10.1186/s12889-015-2100-z
65
Rose, R. D., Buckey, J. C., Zbozinek, T. D., Motivala, S. J., Glenn, D. E., Cartreine, J. A., & Craske, M. G. (2013). A randomized controlled trial of a self-guided, multimedia, stress management and resilience training program. Behaviour Research and Therapy, 51, 106-112. doi:10-1016/j.brat.2012.11.003
66
Salyers, M. P., Hudson, C., Morse, G., Rollins, A. L., Monroe-DeVita, M., Wilson, C., & Freeland, L. (2011). BREATHE: A pilot study of a one-day retreat to reduce burnout among mental health professionals. Psychiatric Services, 62, 214-217. doi:10.1176/ps.62.2.pss6202_0214
67
Rollins, A. L., Kukla, M., Morse, G., Davis, L., Leiter, M., Monroe-DeVita, M., . . . & Collins, L. (2016). Comparative effectiveness of a burnout reduction intervention for behavioral health providers. Psychiatric Services, 67, 920-923. doi:10.1176/appi.ps.201500220
68
Voss-Horrell, S. C., Holohan, D. R., Didion, L. M., & Vance, G. T. (2011). Treating traumatized OEF/OIF veterans: How does trauma treatment affect the clinician? Professional Psychology: Research and Practice, 42, 79. doi:10.1037/a0022297
69
Hensel, J. M., Ruiz, C., Finney, C., & Dewa, C. S. (2015). Meta‐analysis of risk factors for secondary traumatic stress in therapeutic work with trauma victims. Journal of Traumatic Stress, 28, 83-91. doi:10.1002/jts.21998
70
Berger, R., Abu-Raiya, H., & Benatov, J. (2016). Reducing primary and secondary traumatic stress symptoms among educators by training them to deliver a resiliency program (ERASE-Stress) following the Christchurch earthquake in New Zealand. American Journal of Orthopsychiatry, 86, 236-251. doi:10.1037/ort0000153
71
Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015, December). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. In Mayo Clinic Proceedings (Vol. 90, No. 12, pp. 1600-1613). Elsevier.
72
Shapiro, S. L., Brown, K. W., & Biegel, G. M. (2007). Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105
73
Regehr, C., Glancy, D., Pitts, A., & LeBlanc, V. R. (2014). Interventions to reduce the consequences of stress in physicians: a review and meta-analysis. The Journal of Nervous and Mental Disease, 202(5), 353-359.
74
Stamm, B. H. (2010). The concise ProQOL manual.
75
Marine, A., Ruotsalainen, J., Serra, C., & Verbeek, J. (2006). Preventing occupational stress in healthcare workers. Cochrane Database Systematic Review, 4, CD002892. doi:10.1002/14651858.CD002892.pub2
76
Halbesleben, J. R. B., & Demerouti, E. (2005). The construct validity of an alternative measure of burnout: Investigating the English translation of the Oldenburg Burnout Inventory. Work & Stress, 19, 208-220. doi:10.1080/02678370500340728
77
Emery, S., Wade, T. D., & McLean, S. (2009). Associations among therapist beliefs, personal resources, and burnout in clinical psychologists. Behaviour Change, 26, 83-96. doi:0.1375/bech.26.2.83.22
78
Hätinen, M., Kinnunen, U., Mäkikangas, A., Kalimo, R., Tolvanen, A., & Pekkonen, M. (2009). Burnout during a long-term rehabilitation: Comparing lowburnout, high burnout--benefited, and high burnout--not benefited trajectories. Anxiety, Stress & Coping: An International Journal, 22(3), 341-360.http://dx.doi.org/10.1080/10615800802567023.
79
Harrison, R.,& Westwood,M. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective factors. Psychotherapy Theory, Research, Practice, Training, 46, 203-219. doi:10.1037/a0016081.
80
Rupert, P. A., Miller, A. O., & Dorociak, K. E. (2015). Preventing burnout: What does the research tell us? Professional Psychology: Research and Practice, 46, 168-174. doi:10.1037/a0039297 R
81
Rupert, P. A., & Kent, J. S. (2007). Gender and work setting differences in career-sustaining behaviors and burnout among professional psychologists. Professional Psychology: Research and Practice, 38, 88-96. doi:10.1037/0735-7028.38.1.88
82
Stevanovic, P., & Rupert, P. A. (2004). Career-sustaining behaviors, satisfactions, and sources of stress of professional psychologists. Psychotherapy: Theory, Research, Practice, Training, 41, 301-309. doi:10.1037/0033-3204.41.3.301
83
Coster, J. S., & Schwebel, M. (1997). Well-functioning in professional psychologists. Professional Psychology: Research and Practice, 28, 5-13. doi:10.1037/0735-7028.28.1.5
84
Sodeke-Gregson, E. A., Holttum, S., & Billings, J. (2013) Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients European Journal of Psychotraumatology, 4. doi:10. 3402/ejpt.v4i0.21869
85
Cieslak, R., Anderson, V., Bock, J., Moore, B. A., Peterson, A. L., & Benight, C. C. (2013). Secondary traumatic stress among mental health providers working with the military: Prevalence and its work-and exposure-related correlates. The Journal of Nervous and Mental Disease, 201, 917-925. doi:10.1097/NMD.0000000000000034
86
RÃ¥bu, M., Moltu, C., Binder, P. E., & McLeod, J. (2016). How does practicing psychotherapy affect the personal life of the therapist? A qualitative inquiry of senior therapists' experiences. Psychotherapy Research, 26, 737-749. doi:10.1080/10503307.2015.1065354
87
Bagnall, A. M., Jones, R., Akter, H., & Woodall, J. (2016). Interventions to prevent burnout in high risk individuals: Evidence review. Public Health England
Back to top

PTSD Information Voice Mail: (802) 296-6300
Email: ncptsd@va.gov
Also see: VA Mental Health

Facebook Twitter YouTube

Site Map

return to top go